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Background: Real-world data comparing outcomes for prasugrel, ticagrelor and clopidogrel use in patients undergoing percutaneous coronary intervention (PCI) is lacking. Method(s): Patients discharged following PCI and receiving dual anti-platelet therapy were stratified by thienopyridine received. We assessed the association of thienopyridine type with 1 and 2-year MACE (death, MI, stroke) adjusted for baseline clinical/lesion characteristics using data collected prospectively from 14 Australian sites. Secondary endpoints included safety, specifically the incidence of major bleeding (BARC 3,4 or 5) at discharge. Result(s): Data were available for 12,940 procedures from November 2008 until March 2019. Patients receiving prasugrel were more likely to be male, younger (mean age 62.3+/-8.7 years), obese and present with STEMI than those receiving either ticagrelor or clopidogrel (all p<0.001). At 2 years the primary end point occurred less frequently in the prasugrel group than in patients taking ticagrelor or clopidogrel (p=0.03). Conclusion(s): In a large Australian cohort, patients treated with prasugrel after PCI for any indication had significantly lower 2-year rates of death, myocardial infarction and stroke than those receiving either clopidogrel or ticagrelor. Major bleeding did not differ by type of thienopyridine used. [Formula presented]Copyright © 2020